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https://www.readbyqxmd.com/read/29456058/comparison-of-the-9-month-intra-stent-conditions-and-2-year-clinical-outcomes-after-resolute-zotarolimus-eluting-stent-implantation-between-3-month-and-standard-dual-antiplatelet-therapy
#1
Wataru Fujimoto, Takahiro Sawada, Takayoshi Toba, Yu Takahashi, Taishi Miyata, Shogo Oishi, Tsuyoshi Osue, Tetsuari Onishi, Tomofumi Takaya, Akira Shimane, Yasuyo Taniguchi, Hiroya Kawai, Yoshinori Yasaka
BACKGROUND: The use of short-duration dual antiplatelet therapy (DAPT) remains controversial. To investigate efficacy and safety of short-duration DAPT, we performed a detailed comparison of intra-stent conditions by optical coherence tomography (OCT) after second-generation drug-eluting stent implantation with short-term and standard DAPT. METHODS AND RESULTS: Eighty-two consecutive patients with stable angina pectoris who received Resolute zotarolimus-eluting stents (R-ZESs; Medtronic Cardiovascular, Santa Rosa, CA, USA) were enrolled...
February 16, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29454763/early-strut-coverage-in-patients-receiving-drug-eluting-stents-and-its-implications-for-dual-antiplatelet-therapy-a-randomized-trial
#2
Seung-Yul Lee, Jung-Sun Kim, Hyuck-Jun Yoon, Seung-Ho Hur, Sang-Gon Lee, Jin Won Kim, Young Joon Hong, Ki-Seok Kim, So-Yeon Choi, Dong-Ho Shin, Chung-Mo Nam, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong-Ki Hong
OBJECTIVES: This study sought to measure early strut coverage in patients receiving drug-eluting stents (DESs) and to explore the feasibility of short-term dual antiplatelet therapy (DAPT) based on the degree of early strut coverage. BACKGROUND: Data for early strut coverage in patients receiving new-generation DESs, and its implications for DAPT continuation were limited. METHODS: A randomized, multicenter trial was conducted in 894 patients treated with DESs...
February 9, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29454730/short-term-versus-long-term-dual-antiplatelet-therapy-after-drug-eluting-stent-implantation-in-elderly-patients-a-meta-analysis-of-individual-participant-data-from-6-randomized-trials
#3
Seung-Yul Lee, Myeong-Ki Hong, Tullio Palmerini, Hyo-Soo Kim, Marco Valgimigli, Fausto Feres, Antonio Colombo, Martine Gilard, Dong-Ho Shin, Jung-Sun Kim, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Yangsoo Jang, Gregg W Stone
OBJECTIVES: This study sought to evaluate the optimal duration of dual antiplatelet therapy (DAPT) after the implantation of a drug-eluting stent (DES) in elderly patients. BACKGROUND: Qualified studies to evaluate the optimal duration of DAPT in elderly patients have been very limited. METHODS: Using 6 randomized trials that compared short-term (≤6 months) and long-term (12 months) DAPT, individual participant data meta-analysis was performed in elderly patients (≥65 years of age)...
February 8, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29454723/to-encourage-individualized-dual-antiplatelet-therapy-duration-after-drug-eluting-stent-implantation-a-new-page-of-an-intriguing-book
#4
EDITORIAL
Giuseppe Gargiulo
No abstract text is available yet for this article.
February 8, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29449127/evaluating-the-effect-of-six-proton-pump-inhibitors-on-the-antiplatelet-effects-of-clopidogrel
#5
Eugene R Przespolewski, Erica S Westphal, Michelle Rainka, Nicholas M Smith, Vernice Bates, Fran M Gengo
BACKGROUND AND GOAL: Cytochrome P450 (CYP) enzymes are responsible for the conversion of clopidogrel into its active metabolite and the metabolism of proton pump inhibitors (PPIs), which may also inhibit CYP enzymes. A current Food and Drug Administration advisory suggests avoiding esomeprazole and omeprazole while taking clopidogrel because of concerns that PPIs may compromise clopidogrel's antiplatelet effects. The objective of the present study was to examine the robustness of this interaction using a well-controlled study design in a population of participants free of confounders...
February 12, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29448091/evidence-and-prospective-of-plant-derived-flavonoids-as-antiplatelet-agents-strong-candidates-to-be-drugs-of-future
#6
Harron Khan, Mohammad Jawad, Mohammad Ajmal Kamal, Alessandra Baldi, Jianbo Xiao, Seyed Mohammad Nabavi, Maria Daglia
Platelets are involved in hemostasis, inflammation, and thrombosis processes. Following a vascular damage, the endothelium releases protein factors, allowing the adhesion of subendothelium to platelets. Then platelets are activated, leading to the secretion of biologically-active ligands including thromboxane A2, adenosine diphosphate and serotonin. Aspirin, clopidogrel and warfarin are the most common drugs used to meet the challenges of platelet aggregation. However, these agents face issues with aspirin resistance and bleeding...
February 12, 2018: Food and Chemical Toxicology
https://www.readbyqxmd.com/read/29447787/rationale-and-design-of-the-comparison-between-a-p2y12-inhibitor-monotherapy-versus-dual-antiplatelet-therapy-in-patients-undergoing-implantation-of-coronary-drug-eluting-stents-smart-choice-a-prospective-multicenter-randomized-trial
#7
Young Bin Song, Seok Kyu Oh, Ju-Hyeon Oh, Eul-Soon Im, Deok-Kyu Cho, Byung Ryul Cho, Jong-Young Lee, Joo Myung Lee, Taek Kyu Park, Jeong Hoon Yang, Jin-Ho Choi, Seung-Hyuck Choi, Sang Hoon Lee, Hyeon-Cheol Gwon, Joo-Yong Hahn
BACKGROUND AND RATIONALE: Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor reduces thrombotic events in patients undergoing percutaneous coronary intervention (PCI), but these benefits come at the expense of increased risk of bleeding when compared with aspirin monotherapy. It is unclear whether P2Y12 inhibitor monotherapy might maintain anti-ischemic efficacy while reducing the bleeding risk compared with DAPT after implantation of the current generation of drug-eluting stents (DES)...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29447773/percutaneous-coronary-intervention-and-antiplatelet-therapy-in-patients-with-atrial-fibrillation-receiving-apixaban-or-warfarin-insights-from-the-aristotle-trial
#8
David Kopin, W Schuyler Jones, Matthew W Sherwood, Daniel M Wojdyla, Lars Wallentin, Basil S Lewis, Freek W A Verheugt, Dragos Vinereanu, M Cecilia Bahit, Sigrun Halvorsen, Kurt Huber, Alexander Parkhomenko, Christopher B Granger, Renato D Lopes, John H Alexander
BACKGROUND: We assessed antiplatelet therapy use and outcomes in patients undergoing percutaneous coronary intervention (PCI) during the ARISTOTLE trial. METHODS: Patients were categorized based on the occurrence of PCI during follow-up (median 1.8 years); PCI details and outcomes post-PCI are reported. Of the 18,201 trial participants, 316 (1.7%) underwent PCI (152 in apixaban group, 164 in warfarin group). RESULTS: At the time of PCI, 84% (267) were on study drug (either apixaban or warfarin)...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29447770/efficacy-and-safety-of-dual-antiplatelet-therapy-after-coronary-stenting-in-patients-with-chronic-kidney-disease
#9
Doyeon Hwang, Kyung Woo Park, Joo Myung Lee, Tae-Min Rhee, Myeong-Ki Hong, Yangsoo Jang, Marco Valgimigli, Antonio Colombo, Martine Gilard, Tullio Palmerini, Gregg W Stone, Hyo-Soo Kim
BACKGROUND: We compared efficacy and safety of short- (3 or 6 months) versus long-term (≥12 months) dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation, according to the presence of chronic kidney disease (CKD). METHODS: Patient-level pooled analysis was performed with 7242 patients (87.2% with 2nd generation DES) from 5 randomized controlled trials. RESULTS: In both CKD (1273 patients) and non-CKD (5969 patients) population, the rates of patient-oriented composite outcomes at 1-year (POCO, all-cause death, any myocardial infarction [MI], stroke and TIMI major bleeding) were not different between the short- and long-term DAPT (hazard ratio [HR] 1...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29443899/protease-activated-receptor-4-par4-a-promising-target-for-antiplatelet-therapy
#10
REVIEW
Gamariel Rwibasira Rudinga, Ghulam Jilany Khan, Yi Kong
Cardiovascular diseases (CVDs) are currently among the leading causes of death worldwide. Platelet aggregation is a key cellular component of arterial thrombi and major cause of CVDs. Protease-activated receptors (PARs), including PAR1, PAR2, PAR3 and PAR4, fall within a subfamily of seven-transmembrane G-protein-coupled receptors (GPCR). Human platelets express PAR1 and PAR4, which contribute to the signaling transduction processes. In association with CVDs, PAR4 not only contributes to platelet activation but also is a modulator of cellular responses that serve as hallmarks of inflammation...
February 14, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29437885/association-of-different-antiplatelet-therapies-with-mortality-after-primary-percutaneous-coronary-intervention
#11
Ivan Olier, Alex Sirker, David J R Hildick-Smith, Tim Kinnaird, Peter Ludman, Mark A de Belder, Andreas Baumbach, Jonathan Byrne, Muhammad Rashid, Nick Curzen, Mamas A Mamas
OBJECTIVES: Prasugrel and ticagrelor both reduce ischaemic endpoints in high-risk acute coronary syndromes, compared with clopidogrel. However, comparative outcomes of these two newer drugs in the context of primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) remains unclear. We sought to examine this question using the British Cardiovascular Interventional Society national database in patients undergoing primary PCI for STEMI. METHODS: Data from January 2007 to December 2014 were used to compare use of P2Y12 antiplatelet drugs in primary PCI in >89 000 patients...
February 2, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29437014/drug-induced-epistaxis-an-often-neglected-adverse-effect
#12
Sara Meirinho, Ricardo Relvas, Gilberto Alves
BACKGROUND: Epistaxis is an active nose bleeding with a population occurrence of approximately 60%. Although epistaxis is a common clinical complaint, the majority of the cases are benign and caused by local induced factors (e.g., trauma and local inflammation). Nevertheless, it is also recognised that epistaxis can be induced after some drugs intake. AIMS: Due to the increasing use of drugs or drug combinations that potentially may induce epistaxis, this review aims to alert healthcare professionals for this often neglected adverse drug effect and its possible complications...
February 12, 2018: Current Drug Safety
https://www.readbyqxmd.com/read/29436605/novel-iridium-iii-%C3%A2-derived-organometallic-compound-for-the-inhibition-of-human-platelet-activation
#13
Kou-Gi Shyu, Marappan Velusamy, Chih-Wei Hsia, Chih-Hao Yang, Chih-Hsuan Hsia, Duen-Suey Chou, Thanasekaran Jayakumar, Joen-Rong Sheu, Jiun-Yi Li
Since cisplatin achieved clinical success, transition metal platinum (Pt) drugs have been effectively used for the treatment of cancer. Iridium (Ir) compounds are considered to be potential alternatives to Pt compounds, as they possess promising anticancer effects with minor side effects. Platelet activation is associated with the metastasis and progression of cancer, and also with arterial thrombosis. Therefore, it is necessary to develop novel, effective antithrombotic agents. An Ir (III)‑derived complex, [Ir (Cp*) 1‑(2‑pyridyl)‑3‑(3‑methoxyphenyl)imidazo[1,5‑a]pyridine Cl]BF4 (Ir‑3), was developed as a novel antiplatelet drug...
February 7, 2018: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/29433667/inequalities-in-the-use-of-secondary-prevention-of-cardiovascular-disease-by-socioeconomic-status-evidence-from-the-pure-observational-study
#14
Adrianna Murphy, Benjamin Palafox, Owen O'Donnell, David Stuckler, Pablo Perel, Khalid F AlHabib, Alvaro Avezum, Xiulin Bai, Jephat Chifamba, Clara K Chow, Daniel J Corsi, Gilles R Dagenais, Antonio L Dans, Rafael Diaz, Ayse N Erbakan, Noorhassim Ismail, Romaina Iqbal, Roya Kelishadi, Rasha Khatib, Fernando Lanas, Scott A Lear, Wei Li, Jia Liu, Patricio Lopez-Jaramillo, Viswanathan Mohan, Nahed Monsef, Prem K Mony, Thandi Puoane, Sumathy Rangarajan, Annika Rosengren, Aletta E Schutte, Mariz Sintaha, Koon K Teo, Andreas Wielgosz, Karen Yeates, Lu Yin, Khalid Yusoff, Katarzyna Zatońska, Salim Yusuf, Martin McKee
BACKGROUND: There is little evidence on the use of secondary prevention medicines for cardiovascular disease by socioeconomic groups in countries at different levels of economic development. METHODS: We assessed use of antiplatelet, cholesterol, and blood-pressure-lowering drugs in 8492 individuals with self-reported cardiovascular disease from 21 countries enrolled in the Prospective Urban Rural Epidemiology (PURE) study. Defining one or more drugs as a minimal level of secondary prevention, wealth-related inequality was measured using the Wagstaff concentration index, scaled from -1 (pro-poor) to 1 (pro-rich), standardised by age and sex...
March 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29428715/routine-clinical-anti-platelet-agents-have-limited-efficacy-in-modulating-hypershear-mediated-platelet-activation-associated-with-mechanical-circulatory-support
#15
Lorenzo Valerio, Jawaad Sheriff, Phat L Tran, William Brengle, Alberto Redaelli, Gianfranco B Fiore, Federico Pappalardo, Danny Bluestein, Marvin J Slepian
INTRODUCTION: Continuous flow ventricular assist devices (cfVADs) continue to be limited by thrombotic complications associated with disruptive flow patterns and supraphysiologic shear stresses. Patients are prescribed complex antiplatelet therapies, which do not fully prevent recurrent thromboembolic events. This is partially due to limited data on antiplatelet efficacy under cfVAD-associated shear conditions. MATERIALS AND METHODS: We investigated the efficacy of antiplatelet drugs directly acting on three pathways: (1) cyclooxygenase (aspirin), (2) phosphodiesterase (dipyridamole, pentoxifylline, cilostazol), and (3) glycoprotein IIb-IIIa (eptifibatide)...
December 5, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29428263/evidence-based-diagnosis-and-management-of-chronic-subdural-hematoma-a-review-of-the-literature
#16
REVIEW
Vikram Mehta, Stephen C Harward, Eric W Sankey, Gautam Nayar, Patrick J Codd
Chronic subdural hematomas are encapsulated blood collections within the dural border cells with characteristic outer "neomembranes". Affected patients are more often male and typically above the age of 70. Imaging shows crescentic layering of fluid in the subdural space on a non-contrast computed tomography (CT) scan, best appreciated on sagittal or coronal reformats. Initial medical management involves reversing anticoagulant/antiplatelet therapies, and often initiation of anti-epileptic drugs (AEDs). Operative interventions, such as twist-drill craniostomy (TDC), burr-hole craniostomy (BHC), and craniotomy are indicated if imaging implies compression (maximum fluid collection thickness >1 cm) or the patient is symptomatic...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29420954/compliance-with-guideline-directed-medical-therapy-in-contemporary-coronary-revascularization-trials
#17
Ana-Catarina Pinho-Gomes, Luis Azevedo, Jung-Min Ahn, Seung-Jung Park, Taye H Hamza, Michael E Farkouh, Patrick W Serruys, Milan Milojevic, Arie Pieter Kappetein, Gregg W Stone, Andre Lamy, Valentin Fuster, David P Taggart
BACKGROUND: Despite the well-established benefits of secondary cardiovascular prevention, the importance of concurrent medical therapy in clinical trials of coronary revascularization is often overlooked. OBJECTIVES: The goal of this study was to assess compliance with guideline-directed medical therapy (GDMT) in clinical trials and its potential impact on the comparison between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG)...
February 13, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29420189/randomized-comparisons-of-double-dose-clopidogrel-or-adjunctive-cilostazol-versus-standard-dual-anti-platelet-in-patients-with-high-post-treatment-platelet-reactivity-results-of-the-creative-trial-clopidogrel-response-evaluation-and-anti-platelet-intervention
#18
Yi-Da Tang, Wenyao Wang, Min Yang, Kuo Zhang, Jing Chen, Shubin Qiao, Hongbing Yan, Yongjian Wu, Xiaohong Huang, Bo Xu, Runlin Gao, Yuejin Yang
Background -Patients undergoing percutaneous coronary intervention (PCI) react differently to antiplatelet drugs. Those with low responsiveness to clopidogrel have a higher risk of cardiac ischemic events. The goal of this study is to conduct a head-to-head comparison of the safety and effectiveness of intensified antiplatelet therapies (either double-dose clopidogrel [DOUBLE] or adjunctive cilostazol [TRIPLE]) and conventional strategy (STANDARD) in post-PCI patients. Methods -In this single-center, randomized, controlled trial, we used thromboelastography (TEG), a platelet function test, to select 1078 PCI patients at high thrombotic risk and compared the intensified antiplatelet therapies with standard antiplatelet therapy...
February 2, 2018: Circulation
https://www.readbyqxmd.com/read/29418039/topical-tranexamic-acid-for-epistaxis-in-patients-on-antiplatelet-drugs-a-new-use-for-an-old-drug
#19
Michael S Runyon
"The remedy is worse than the disease." - Francis Bacon While Bacon may not have been referring specifically to antiplatelet drugs, one cannot blame the emergency physician expressing this same sentiment while caring for a patient presenting with epistaxis while on one of these medications. Achieving hemostasis in these cases can be challenging for the very best emergency physician, and a miserable experience for the most stoic of patients. In this issue of Academic Emergency Medicine, Zahed, et al. This article is protected by copyright...
February 8, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29415754/guanxinning-tablet-for-patients-who-switch-from-dual-antiplatelet-therapy-to-aspirin-alone-after-percutaneous-coronary-intervention-study-protocol-for%C3%A2-a-cluster-randomized-controlled-trial
#20
Jingen Li, Jianqing Ju, Zhuo Chen, Jing Liu, Fang Lu, Rui Gao, Hao Xu
BACKGROUND: One-year dual antiplatelet therapy (DAPT), generally aspirin in combination with a P2Y12 receptor inhibitor, has been a standard treatment for patients undergoing percutaneous coronary intervention (PCI). Prolonged DAPT has proven itself effective in further reducing cardiovascular events, yet with increased risk of bleeding. Thus, it is of great necessity to find an alternative drug that is as effective but safer and more economic than the P2Y12 inhibitors after termination of one-year DAPT...
February 7, 2018: Trials
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